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Can a dementia care facility evict and forcibly remove a patient from the Memory care facility if the responsible POA does not approve a care cost increase? What options are there? Sure, we could pay the bill, but it's a matter of principle. We hope to move the parent shortly as the MC facility looks for more and more ways to squeeze the responsible parties for increased care costs. This MC facility in Northern California recently lost a multi-million judgment in a wrongful death case. We feel they will try to raise fees at all of their MC facilities and this pattern has emerged about every 4-6 months when the parent seems about the same.

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Gnarly, so your mom is on hospice? In a MC and on hospice? And she is at the point where she on her own cannot go to meals? or participate in activities or events that other MC residents do? Is this accurate?
and
Is She at all bathing / showering on her own? Or is this being only done by hospice when they come in for their visits?
If so, You may want to have moved into a NH/SNF. Ask Nursing staff at the MC on having mom get an outside assessment done.

The reason why is most MC are registered under Assisted Living for licensing. It may be a locked ward or secured enclosure for how the facility is designed, but how it runs for its care services is under AL. And AL means that the residents are able to do & participate in their ADLS with some assistance from their staff. (fwiw services the hospice provides do not factor in for staff services the MC itself does). If a resident requires consistent numerous daily assistance to live in this MC, the facility can add on fees to do this support. The biggest extra billing is medication management, aka help in taking their meds. AL or a MC adding on medication management as a cost to their baseline bill is kinda standard practice.

Is this correct…. that mom is eating almost all her meals in her room?
So she is not going over to the community dining room, but eating in her room. If so, that requires extra staffing time both for dietary and for housekeeping. Yeah the facilty is going to find a way to increase her bill to offset costs they incur by this. There is no “approval requirement” necessary for a facilty to raise their rates or add on fees. There’s a contract that was signed and if this MC in its contract allows rates & fees to change due to extra staffing time needed, then they can raise costs. Usually it’s a Notice of a fee increase that will start 30/60 days so it allows a resident to let the facilty know they are leaving without incurring extra costs.

If mom is being very sedentary or is bedfast for most of the day, she may be best off in a NH. For those without resources to pay, they can apply for LTC Medicaid program as it will pay for custodial costs in a NH/SNF. The program does have “at need” requirements both medical and financial, with a 5 yr lookback on financials.

An AL or MC can evict a residents. If it’s runs under AL for its licensing, the resident is there u pnder the expectation that they can in fact do most of their ADLs with assistance on occasion. AL do not have the required to do “continuity of care” that’s skilled nursing facility does. So they can be evicted, or sent to a shelter. Thats bad optics, so what tends to happen is that EMS is called and the resident goes off via EMS to the ER/ED of a hospital and then when the discharge planner at the hospital contacts the AL or the MC, they are told that the facilty will not take them back as they cannot proved the level of care needed. The next call by the discharge planner will be to family to come and pick up their elder.

perhaps laps speak with the hospice agency as to what Nh may be a better fit for your mom.
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The law where I am says a facility has to give 30 days notice when asking a resident to leave. I'm not sure what happens if the resident/family refuses.

The facility I am most familiar with charges extra to routinely bring meals to a resident's room, because it is extra work. I understand your mother's reasoning for it, so it seems worthwhile to go ahead and pay for the service for her. Is she the only one, in which case you might negotiate a lower price, or are there others, so it is a set price? Or they may feel that she has declined to a point where she needs oversight in the dining room because she is at risk of choking or they found that she wasn't eating much and needed encouragement.

As for showering, state regulations here require that a resident be showered/bathed at least twice a week. Maybe an investigation revealed that they were not meeting the requirements in your state and so they are coming into compliance.

Have you talked with them about why they are making these changes for your mother?
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BurntCaregiver Feb 17, 2025
@MG

What happens if the resident or their family refuses to move them is they get a court-order for them to be moved to another facility and they get moved. They are not allowed to just put a person out onto the curb.
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They will raise the fees at all of their facilities because of the multi-million dollar judgment. These places don't even need a reason to raise their fees.

Hold off paying them the increase for as long as you can. When your parent is safely in residence at a different facility, burn the old on the fee increase they're demanding.

These places get you coming and going. The only ay to get around the new fee increase the facility demands is to move your parent to a different place then hope they don't do the same. They probably will at some point though.
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When prices go up, the options are
1) buy the product
2) do NOT buy the product.

There is no option 3, where you refuse the price but still get the product.
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Gnarley Feb 17, 2025
Alvadeer, Sorry, but your way of thinking is not helpful and not the only option. From your way of thinking there are only two options, yes and no when there are more options when you ask. When moving someone into MC many times it's a oneway direction, they hook you into coming in, and then, the larger operations are predatory and this isn't something you learn about when you need to get help for your LO, you might need to get them into a place quickly and have limited options. Then once you sign a contract and months go by you find out how their pricing works. Rolling over and accepting what they tell you they think is needed is as foolish as giving your bank account to someone you don't know because they told you your computer is going to crash.

We all have choices and some don't show the options until you push back and ask for more info.
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This should be in your initial contract. Memory care facilities (at least in my area) are privately owned and each has contract will detail all scenarios like care cost increases and medical evaluation criteria.

Ask for the medical evaluation that indicates a care cost increase is necessary and compare to the previous or initial evaluation. If you feel this is purely a money grab consult with a lawyer for options regarding eviction.
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Reply to AMZebbC
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You are obligated to pay facility increases whether you agree with the charges or not. Very few of us who have had loved ones in care agree with rate increases, but if we want our LO to continue residing there, we pay the fees. I'm quite sure a private facility can have a resident removed by the sheriff or whatever, but who wants to find out?? Sometimes the principle of the thing has to be overlooked in favor of peace.
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Gnarley Feb 17, 2025
There is a facility increase once a year, 10%, like it or not. The recent reassessment now has them coming to get my mom out of her room for all meals and eat in the main dining rooms. Over the last 15 months, she's rarely left her room, and they have fed her in there 99% of the time. With no medical necessity, they decided to change up and take her out. She doesn't want to eat in the noisy chaotic dining room. I've been with her there a few times and it's like One flew over Cuckoo's Nest and some of the residents come to sit and fidget while she's eating and stare at her and disrupted her ability to eat, she doesn't like it so why would they force her when it's not medically necessary and they have been feeding her in her room for 15 months? Making that change adds another $400 to the bill every month. I don't believe they can make those decisions without support from the family, and her hospice provider.
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It would be an unsafe discharge to force her out if she has no place to go. Your contract should read the facility needs a 30 day notice that resident is living. Pay for the 30 days giving you a chance to find a better place.

These are private facilities. They can do whatever they want. See if there is rent control in the Township the facility is in. If so, they may not be able to raise rent over a certain %. I would question the bathing. I picked how many times I wanted Mom bathed and the cost was in her personal care. 3x cost more than 2x a week.
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Reply to JoAnn29
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Yes, if prices go up and they are not paid the resident can be asked to leave.
Read your care contract signed when mother entered the facility.
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Gnarley Feb 14, 2025
Ok, asked to leave, that's different than being physically taken out of the facility. we're also not suggesting not paying, we're looking at not signing and agreeing with an increase we disagree with, make sense? If the MC wants an increase where they are now attending much more than the resident needs and removing them from their room for all 3 meals when they hadn't previously, that requires more effort, we didn't approve of the changes and neither would the resident as she dislikes the noise and interruptions in the dining areas. She wants to eat in her room as she has been for the last year where it's quiet and she can enjoy her music. Suggesting she needs showering 2-3 days a week when she has showered mostly 1 time a week for many years now seems very excessive and not needed.
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